Harmonization of Amoxicillin Dose, Duration, and Formulation for Acute Childhood Respiratory Infections

Author:

Dharmapalan Dhanya1,Bielicki Julia2,Sharland Mike2

Affiliation:

1. Consultant in Pediatric Infectious Diseases, Apollo Hospitals, Navi Mumbai 400614, India

2. Centre for Neonatal and Paediatric Infection, Institute of Infection and Immunity, St. George’s University of London, Cranmer Terrace, London SW17 0RE, UK

Abstract

Pediatric guidelines vary in their recommended amoxicillin dosing for common respiratory infections. It would help program delivery if there was harmonization of dosing and formulation of amoxicillin across multiple clinical respiratory infections, considering the pharmacokinetics, common targets, drug resistance, availability, cost effectiveness, and ease of administration. The World Health Organization EML AWaRe Book recommends higher dose amoxicillin given twice daily for five days for all uncomplicated respiratory infections where an antibiotic is indicated. The WHO AWaRe Book amoxicillin dosing guidance can be achieved for infants and older children using only scored 250 mg and 500 mg dispersible tablets (DTs), the WHO recommended child formulation. There is a clear need for wider availability of 250 mg/500 mg dispersible tablets of amoxicillin in both public and private health care sectors, to improve access to essential antibiotics.

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology

Reference32 articles.

1. World Health Organisation (2022). The WHO AWaRe (Access, Watch, Reserve) Antibiotic Book.

2. Indian Council of Medical Research (2023). Treatment Guidelines for Antimicrobial Use in Common Syndromes, Indian Council of Medical Research.

3. GAPPS (Grading and Assessment of Pharmacokinetic-Pharmacodynamic Studies) a Critical Appraisal System for Antimicrobial PKPD Studies-Development and Application in Pediatric Antibiotic Studies;Gastine;Expert Rev. Clin. Pharmacol.,2019

4. Inaccuracies in Dosing Drugs with Teaspoons and Tablespoons;Falagas;Int. J. Clin. Pract.,2010

5. Singh, V., and Yewale, V. (2014). IAP Consensus Guidelines on Rational Management of Respiratory Tract Infections in Children, Indian Academy of Pediatrics.

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